Dissecting the functional outcomes of first episode schizophrenia spectrum disorders: a 10-year follow-up study in the PAFIP cohort.

BACKGROUND: The aim of the current study was to examine the heterogeneity of functional outcomes in first episode psychosis (FEP) patients and related clinical, neurocognitive and sociodemographic factors using a cluster analytic approach. METHOD: A large sample of FEP patients (N = 209) was functionally reassessed 10 years after the first contact with an early intervention service. Multiple baseline, 3-year and 10-year follow-up variables were explored. RESULTS: The cluster analysis emphasized the existence of six independent clusters of functioning: one cluster was normal overall (42.16%), two clusters showed moderate interpersonal (9.63%) or instrumental (12.65%) deficits, two clusters showed more severe interpersonal (12.05%) or interpersonal and instrumental (13.85%) deficits and there was a significantly overall impaired cluster (9.63%). Cluster comparisons showed that several baseline and follow-up factors were differentially involved in functional outcomes. CONCLUSIONS: The current study demonstrated that distinct clusters of functioning in FEP patients can be identified. The fact that a variety of profiles was observed contributes to a better understanding of the nature of the heterogeneity characterizing FEP patients and has clinical implications for developing individualized treatment plans.

Toxoplasma infection in kidney donors and transplant recipients from Western Mexico: A one-year follow-up.

PURPOSE: Solid organ transplant recipients are highly susceptible to Toxoplasma gondii infection. We aimed to describe the 12-month follow-up risk of seroconversion in renal transplant recipients. METHODOLOGY: Anti-T gondii antibodies were investigated in donors and recipients of renal transplants. In donors, anti-T gondii were evaluated before transplantation. In recipients, anti-T gondii were monitored over a 12-month period to evaluate potential seroconversion or reactivation. IgG and IgM anti-T gondii antibodies were investigated through enzyme immunoassay and Western blot. Molecular diagnosis was performed on peripheral blood leukocytes using PCR to amplify fragments corresponding to the T gondii B1 gene and the repetitive 529-bp element. RESULTS: The basal frequency of seropositive IgG anti-T gondii antibodies was higher in donors than in recipients (38.4% vs 25.2%; P = .03). During the 12-month follow-up, the accumulated seroconversion to IgG and IgM antibodies was 3/99 (3.0%), and the accumulated reactivation was 11/99 (11.0%). None of the samples exhibited positivity to T gondii DNA. CONCLUSIONS: This study showed that there is an increased risk of seroconversion or reactivation in renal transplant recipients over a 12-month follow-up. Our data suggest that prophylaxis with trimethoprim and sulfamethoxazole effectively prevented toxoplasmosis, since neither T gondii DNA nor clinical toxoplasmosis was detected.

Quality of life in early phases of panic disorder: predictive factors.

OBJECTIVE: To analyse the quality of life (QoL) of patients with panic disorder of recent onset and to find related clinical variables. METHOD: Panic disorder patients with and without agoraphobia (N=125) in the first stages of the disorder (median of 8 months since the first panic attack) were compared with a community control group. Quality of life was evaluated by 36-item Short-Form Health Survey (SF-36) and by a single-item scale evaluating subjective well-being. RESULTS: Panic disorder patients had worse scores than the general population in all of the dimensions of the SF-36. Anxiety and depressive symptoms, age, frequency of panic attacks and agoraphobic avoidance accounted for 18-42% of the variance in QoL scores. Frequency of panic attacks and agoraphobic avoidance were variables accounting for poor QoL in physical functioning and mental health respectively. However, unspecific factors in addition to panic symptomatology, particularly depressive and anxiety symptoms, significantly contribute to the worse QoL of these patients. CONCLUSION: Panic disorder of recent onset is a deteriorating condition. Clinical variables do not equally affect mental health and physical functioning, and unspecific factors in addition to panic contribute to the poor QoL.